https://www.frontiersin.org/articles/10.3389/fimmu.2018.00229/full … Interesting hypothesis for how CFS works. An infection causes an immune response; some of the antibodies produced attack mitochondria (which, after all, originated as bacteria) and make energy metabolism less efficient, causing fatigue.
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Primary biliary cirrhosis, another disorder that is associated with severe exercise-induced fatigue, occurs when autoantibodies target lipoic acid, a small fatty acid added to the pyruvate dehydrogenase complex. The theory here is that PBC causes fatigue via blocking respiration.
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CFS patients also have much lower ADP and ATP (as you'd expect if they had a defect in cellular respiration).
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CFS patients have low levels of the metabolites in the citric acid cycle, which also indicates mitochondrial dysfunction. https://www.nature.com/articles/srep34990 … No citric acid cycle, no NADH; no NADH, no ATP.
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likewise, CFS patients are low in glutamine, used in the citric acid cycle: https://s3.amazonaws.com/academia.edu.documents/40582677/NMR_metabolic_profiling_of_serum_identif20151202-4950-19cc6bh.pdf?response-content-disposition=inline%3B%20filename%3DNMR_metabolic_profiling_of_serum_identif.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=AKIAIWOWYYGZ2Y53UL3A%2F20200309%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200309T202941Z&X-Amz-Expires=3600&X-Amz-SignedHeaders=host&X-Amz-Signature=cfd9b4bc7026e527a48cfc58996700aeee13478209f53e0e376003c0abe82857 …
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